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A pilot project called Better Together provided home-based palliative care in the U.K. and reduced hospital admissions for patients with advanced congestive heart failure and increased the likelihood they would die at home or in hospice. Researchers reported in BMJ Supportive and Palliative Care that the team-based program was designed to identify and manage patients who did not respond to treatment.

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Patients with hematologic cancers were least likely to die at home or in hospice, according to a study published in PloS Medicine. Patients who were divorced, widowed or single were less likely than married patients to die at home or in hospice.

Baby boomers who become caregivers for parents can find it has serious financial consequences, especially if their retirement savings and other investments were reduced by the recession, Elizabeth O'Brien writes in her Retire Well column. Many caregivers do not have a long-term strategy and begin to look ahead only when a parent needs help. The first step is to start a family discussion, she writes.

Patients and families need help coping with their feelings, hopes and fears along with symptoms of disease, and not just treatment for their illnesses, Dr. Ira Byock told MidMichigan Health's 12th Annual Spiritual Care Conference. A "shift of mindset" is needed for health care professionals because their training is so focused on medical aspects of care, he said. Advance directives help foster communication and counseling for families making stressful decisions, he said.

Scripps Health asked a bankruptcy court for permission to acquire the assets of the San Diego Hospice, which said it would close in the aftermath of a Medicare audit of its enrollment policies. "I think there's a growing understanding of hospice care for society and it makes sense for us to have it within our system," said Scripps CEO Chris Van Gorder, who added with court approval the company would be able to offer appropriate care based on patient preferences.

Indiana University researchers surveyed primary care physicians about colon cancer screening using different patient examples and found 45% would test a 50-year-old with unresectable lung cancer, 37% would test a similar 65-year-old and 25% would test an 80-year-old person with that diagnosis. University of California at San Francisco geriatrics professor Dr. Ken Covinsky in GeriPal writes that it is difficult to envision physicians considering colon cancer tests for these patients "thinking clearly about the extensive range of palliative services their patient really needs."